Silver plans offered through the exchanges may require patients to pay more than twice as much out of pocket for prescription medicines as they would under a typical employer plan, offering employers a prime opportunity to use health care benefits as retention and recruitment tools for their employees.

Silver plans — the second lowest coverage tier on the Affordable Care Act’s public health insurance exchanges — impose 130% higher cost sharing for prescription medicine, along with a combined deductible, than typical employer-sponsored plans, according to a new report by the Seattle, Wash.-based Milliman Inc., a consulting company. The Milliman report also notes that silver plans are nearly four times more likely to have a single combined deductible for medical and pharmacy benefits (46% of the time) compared to typical employer-sponsored plans (12%).

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